Stenting for difficult or large gallstones.
Occasionally longterm palliation with stents may be considered. Following sphincterotomy, two pigtail stents have been placed to prevent large residual stones from becoming impacted in the lower bile duct (Fig. 4.197). The endoscopic appearance of these stents from the duodenal aspect is shown in Fig. 4. 198. There is however a continuing risk of complications such as ascending cholangitis.
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